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Home : Zika Fever

What is Zika Fever?

Zika Fever (also known as Zika virus disease) is an illness caused by the Zika virus. Symptoms are similar to dengue fever. Most cases (60–80%) have no symptoms. When symptoms are present, they generally include fever, red eyes, joint pain, headache, and a maculopapular rash.

In general, Zika fever symptoms are mild and last less than seven days. Deaths have not occured during the initial infection as of 2015. Infection has been linked to Guillain–Barré syndrome.

The virus causing the disease was first isolated in 1947. The first documented outbreak among people occurred in 2007 in the Federated States of Micronesia. As of January 2016, the disease was occurring in twenty regions of the Americas. It is also known to occur in Africa, Asia, and the Pacific.

Due to the outbreak starting in Brazil in 2015, the World Health Organization (WHO) declared it a Public Health Emergency of International Concern in February 2016.

Cause and Transmission of Zika Fever

Zika virus is a mosquito-borne flavivirus closely related to dengue virus. While mosquitoes are the vector, the reservoir species remains unknown, though serological evidence has been found in West African monkeys and rodents.

Transmission is via the bite of mosquitoes from the Aedes genus, primarily Aedes aegypti in tropical regions. It has also been isolated from A. africanus, A. coargenteus, A. luteocephala, A. vitattus and A. furcifer. During the 2007 outbreak on Yap Island in the South Pacific, Aedes hensilli was the vector, while Aedes polynesiensis spread the virus in French Polynesia in 2013.

There have also been confirmed reports of two cases of sexual transmission and cases of vertical perinatal transmission. Like other flaviviruses it could potentially be transmitted by blood transfusion and several affected countries have developed strategies to try and screen blood donors.

 
Zika Fever Symptoms

The most common symptoms of Zika fever are fever, rash, conjunctivitis (red eyes), muscle and joint pain, and headache, (similar to symptoms of dengue and chikungunya fever).

The incubation period is not well characterized as yet, but is probably a few days to a week. The disease lasts for several days to a week and is sufficiently mild that hospitalization is not usually required. Death is rare.

Bleeding have been documented in only one instance, hematospermia (blood in semen).

 
Pregnant Women and Zika Virus Infection

It is believed that the disease may be spread from mother-to-child in the womb and cause microcephaly. However, there are very few reports in the literature.

In November 2015, reports from the Brazilian Health Ministry alerted people to a connection between the Zika virus and newborn microcephaly in Northeastern Brazil based on two cases of severely affected babies in whom amniocentesis confirmed the presence of the Zika virus in the amniotic fluid.

The ultrasound findings in these two fetuses, as reported on 5 January 2016, showed that both have a small head circumference (microcephaly) due to the destruction of different parts of the brain. One of the fetuses was also found to have calcifications in their eye and microphthalmia.

The Brazilian Ministry later confirmed the previously suspected connection between Zika infection in pregnant women and newborn microcephaly, with at least 2,400 suspected cases of microcephaly in the country in 2015 as of 12 December, and 29 fatalities.

 
Zika Fever Diagnosis

It is difficult to diagnose Zika virus infection based on clinical signs and symptoms alone due to overlaps with other arboviruses that are endemic to similar areas. Zika virus can be identified by RT-PCR in acutely ill patients.

However, the period of viremia can be short and the World Health Organization recommends RT-PCR testing be done on serum collected within 1 to 3 days of symptom onset or on saliva or urine samples collected during the first 3 to 5 days.

Later on, serology through detection of specific IgM and IgG antibodies can be used. IgM can be detectable within 3 days of the onset of illness. Serological cross-reactions with closely related flaviviruses such as dengue and west nile fever as well as vaccines to flaviviruses are possible.

 
Zika Fever Prevention

There is currently no vaccine, but development is a priority of the National Institutes of Health. The virus is spread by mosquitoes, making vector control and avoidance an essential element to disease control. The US Centers for Disease Control recommends that individuals:

• Cover exposed skin by wearing long-sleeved shirts and long pants.
• Use an insect repellent.
• Always follow product directions and reapply as directed.
• In case of using sunscreen, apply sunscreen first, let it dry, then apply insect repellent.
• Avoid applying repellent to children's hands, eyes, or mouth.
• Stay and sleep in screened-in or air-conditioned rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

 
Zika Fever Treatment

There is currently no specific treatment for Zika virus infection. Care is supportive with treatment of pain, fever, and itching. Some authorities have recommended against using aspirin and other NSAIDs as these have been associated with hemorrhagic syndrome when used for other flaviviruses. Additionally, aspirin use is generally avoided in children when possible due to the risk of Reye syndrome.

Zika virus had been relatively little studied until the major outbreak in 2015, and no specific antiviral treatments are available as yet.

Advice to pregnant women is to avoid any risk of infection so far as possible, as once infected there is little that can be done beyond supportive treatment. One in vitro study found that Zika virus may be sensitive to interferon treatment, which is commonly used against other viral infections, however these results have not been tested in animals or humans.

 
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